Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Feb 25, 2023
Date Accepted: Jun 15, 2023
The combined effects of short-term exposure to multiple meteorological factors on unintentional drowning mortality: a large case-crossover study in China
ABSTRACT
Background:
Drowning is a serious public health problem in the world. Previous epidemiological studies on the association between meteorological factors and drowning mainly focused on individual weather factor, and it is unclear on the combined effect of mixture exposure to multiple meteorological factors on drowning.
Objective:
To investigate the combined effects of multiple meteorological factors on drowning mortality in China, and identify the important meteorological factors contributing to drowning mortality.
Methods:
Drowning mortality data from May 1 to September 31 during 2013-2018 was collected from five provincial vital register systems in China, and daily meteorological data including daily mean temperature, relative humidity, sunlight duration and rainfall at the same period were obtained from the Chinese Academy of Meteorological Science Data Center. We constructed a time-stratified case-crossover design and applied generalized additive model to examine the effect of individual weather factor on drowning mortality, and then quantile g-computation was employed to estimate the joint effect of the mixture exposure of meteorological factors.
Results:
A total of 46179 drowning deaths were reported from five provinces in China during 2013-2018. In effect analysis of individual exposure, we observed positive effect for sunlight duration, negative effect for relative humidity, and U-shaped associations of temperature or rainfall with drowning mortality. In joint effect analysis of the above four meteorological mixtures, 2.99% (95% CI: 0.26%, 5.80%) increase in drowning mortality was observed for per quartile rise of the mixture exposure. For total population, sunlight duration was the most important weather factor of drowning mortality, with 93.1% positive contribution to the overall effects, while rainfall was mainly negative factor of drowning deaths (90.5%), and temperature and relative humidity contributed to 6.9% and -9.5% to the overall effects, respectively.
Conclusions:
This study found that mixture exposure to temperature, relative humidity, sunlight duration and rainfall was positively associated with drowning mortality, and sunlight duration rather than temperature may be the most important meteorological factor of drowning mortality.
Citation
The author of this paper has made a PDF available, but requires the user to login, or create an account.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.